Healthcare Provider Details

I. General information

NPI: 1831680610
Provider Name (Legal Business Name): ROSE ANN SABIO BELTRAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2018
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3772 TIBBETTS ST
RIVERSIDE CA
92506-2605
US

IV. Provider business mailing address

9500 GILMAN DR
LA JOLLA CA
92093-5004
US

V. Phone/Fax

Practice location:
  • Phone: 888-743-7526
  • Fax:
Mailing address:
  • Phone: 858-534-2230
  • Fax: 858-534-7545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95136174
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: